NICOTIAN A TABACUM -711
insecticide, especially in agricultural districts. In 1926, a labourer - of Kent,
who had used nicotine as an insecticide and kept it on a shelf in the kitchen
with other bottles containing non-poisonous medicine, took some of the nico-
tine by mistake and died immediately. The following cases are the examples
of severe nicotine poisoning as a result of absorption through the skin : —
1. In the process of making an insecticide, a girl, 22 years old, accident-
ally spilt about 2 drachms of a 95 per cent solution of nicotine on her overall
sleeves. She changed the overall and washed her arm under the hot tap,
dried herself, wiped her damp jumper sleeve, and went on with her job.
Twenty minutes later she collapsed.5
2. A man, aged 35, sat down in a chair on the seat of which some
" Nico-Fume Liquid" (a 4 per cent solution of free nicotine) had been
spilled. He felt the solution wet through his clothes to the skin over the
left buttock, an area of about the size of a palm, and recognized what it was
by its characteristic odour. In about 15 minutes he was seized with severe
symptoms of poisoning and recovered in 4 days.6
Soldiers sometimes apply tobacco to the skin with a view to becoming
sick and thus escaping military duty. The usual method of malingering is to
soak two strong cheroots in water for some hours, and to place at bed time
one in each axilla, which is held in position by a bandage. The following
morning poisonous symptoms supervene, so that the malingerer is unable
to attend to duty. In order to ensure greater certainty of the effects, the
water in which the cigars have been soaked is taken internally. Deacon7
describes the case of an Italian soldier who thus suffered from tobacco poison-
ing at the time of expiry of his leave, so that he was reported sick.
Suicidal and homicidal cases of tobacco poisoning are rare. Douglas
Cowburn8 reports the case of a woman who took an insecticide consisting
of a mixture of nicotine apparently with suicidal intent, and who was sub-
sequently found dead in a field with the empty bottle by her side which
had contained the poison. In the celebrated case of Count Bocarnie, nico-
tine was administered to the brother of the Countess by force. Tobacco
used to be a common agent for infanticide in the districts of Agra and
Gwalior. It has also been employed to procure abortion.
In addition to nicotine, tobacco smoke emanating from cigarettes, cigars
and pipe tobacco contains carbon dioxide, carbon monoxide, hydrocyanic
acid, hydrogen sulphide, ammonia and pyridine, which are responsible for
the irritation of the throat and respiratory passages.
Nicotine is eliminated partly by the lungs, but chiefly in the urine, the
secretion of which it increases. It is also detected in the saliva and sweat.
In nursing mothers who smoke excessively nicotine may be found in the
breast milk. Lessage9 asserts that wet nurses who chew or smoke tobacco
can poison the babies they nurse and the symptoms produced are digestive
disturbances, restlessness, dyspnoea, bradycardia, syncope, collapse and
A case10 is recorded where a breast-fed infant, six weeks old, whose mazier
smoked twenty cigarettes a day, suffered from restlessness, insomnia, spastic vomiting,
diarrhoea, rapid pulse and circulatory disturbances. The infant recovered after the
4. A. Douglas Cowburn, Med.-Leg. and CriminoZog. Rev., April 1933, p. 120.
5. Lockhart, Brit. Med. Jour., Feb. 11, 1933, p. 246.
6. Faulkner, Jour. Amer. Med. Assoc., May 27, 1933, p. 1664.
7. Brit. Med. Jour., July 10, 1923, p. 61.
8. Med.~Leg, and Criminology. Rev., April 1933, pp. 120-121.
9. Jour. Amer. Med. Assoc., June 6, 1926, p. 1787.
10. Wyckerheld Bisdan, Maandschrift voor Kindergeneskunde, Leyden, May 1937, p.
332; Jour, Amer. Med. Assoc., July 10, 1937, p. 178.